Onkológia 6/2025
Current treatment approaches for acute myeloid leukemia in Slovakia
Acute myeloid leukemia (AML) is one of the most common acute leukemias in adults, with an incidence in Europe of approximately 3–5/100,000 per year and a rising occurrence in older age groups. Over the last decade, diagnostics, risk classification and therapy of AML have undergone a major transformation. The updated ELN 2022 recommendations have redefined genetic risk stratification and response criteria, including the role of measurable residual disease (MRD), which directly influences the choice between intensive and less intensive first-line therapy, the indication for allogeneic hematopoietic stem cell transplantation (alloHSCT), and the use of maintenance treatment. In addition to standard intensive chemotherapy (the “7+3” regimen) combined with targeted agents (e.g. midostaurin for FLT3-mutated AML, gemtuzumab ozogamicin for CD33-positive AML), liposomal daunorubicin/cytarabine (CPX-351) has been introduced for therapy-related AML and AML with myelodysplasia- related changes (t-AML, AML-MRC), and combinations of hypomethylating agents with venetoclax have become standard in medically unfit patients. In relapsed/refractory AML, FLT3 inhibitors (gilteritinib), selection of salvage regimens according to the molecular profile and rapid referral for alloHSCT upon achievement of remission and/or MRD negativity play a key role. This article summarizes current international recommendations and therapeutic options available in Slovakia, the practical availability of individual drugs in routine clinical practice, and specific aspects of AML management in the local setting (diagnostic panel, choice of induction therapy, and post-consolidation treatment).
Keywords: myeloid leukemia, ELN 2022, venetoclax, CPX-351, FLT3 inhibitors, allogeneic hematopoietic stem cell transplantation
